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Authors

 

Biljana Milić^1,2, Tatjana Ilić^1,2 , Tanja Janković^2,3 , Sonja Golubović^1,2 , Olgica Latinović-Bošnjak⁴ , Katarina Ilić <sup>5

1</sup>Klinički Centar Vojvodine, Klinika za nefrologiju i kliničku imunologiju, Novi Sad
²Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad
³Specijalna bolnica za reumatske bolesti, Novi Sad
⁴Klinički Centar Vojvodine, Klinika za gastroenterologiju i hepatologiju, Novi Sad
⁵Roche,d.o.o., Beograd, Srbija

 

UDK: 616.45-089-06(497.11)"2012/2016"

The paper was received / Rad primljen: 03.05.2020.

Accepted / Rad prihvaćen: 26.05.2020.

 

Correspondence to:

Biljana Milić,
Puškinova 22, Novi Sad,
021/ 452213, 063/7197561,
e-mail: biljana.milic@ mf.uns.ac.rs

 

 

Sažetak

 

Cilj rada: Utvrditi razlike između muškaraca i žena obolelih od ankilozirajućeg spondilitisa (AS) u pogledu kliničke prezentacije, aktivnosti bolesti, funkcionalnog statusa i odgovora na terapiju inhibitora tumorskog faktora nekroze alfa (TNF-α inhibitor). Metode: Studija je obuhvatila 59 AS bolesnika lečenih TNF-α inhibitorom tokom najmanje 12 nedelja. Uvođenje i procena terapijskog odgovora na TNF-α inhibitor je sprovedena prema ASAS-EULAR preporukama za lečenje ove bolesti. Klinički i demografski parametri su upoređivani između muških i ženskih bolesnika. Rezultati: Od ukupnog broja bolesnika, 24(40,68%) su bile žene i 35(59,32%) muškarci. Žene su bile starije od muškaraca u momentu ispitivanja (p=0,049), u vreme postavljanja dijagnoze (p=0,05) kao i započinjanja biološkog leka (p=0,009). Takođe, kod žena se značajno duže kasnilo sa dijagnozom bolesti u odnosu na muškarce (p=0,017). Nije bilo razlike između polova u pogledu prevalence humanog leukocitnog antigena (HLA)-B27, niti prisustva perifernog artritisa, daktilitisa, entezitisa, uveitisa ili inflamatorne bolesti creva (IBD). Parametri vezani za aktivnost bolesti i funkcionalni status se takođe nisu razlikovali između grupa. Muškarci su duže vreme ostajali na prvom TNF-α inhibitoru (p=0,031). Ukupno pet bolesnika je iskazalo primarnu ili sekundarnu neefikasnost na TNF-α inhibitor, od toga jedna žena (4.2%) i četiri muškarca (11,4%) (p=0,61). Svi bolesnici su nastavili lečenje drugim TNF-α inhibitorom što je bilo praćeno dobrim kliničkim odgovorom. Zaključak: U našem uzorku AS bolesnika prisustvo ženskog pola je bilo vezano za duže kašnjenje u postavljanju dijagnoze bolesti. Bolesnici se nisu međusobno razlikovali u pogledu neefikasnosti na prvi TNF-α inhibitor, ali su muškarci bili duže lečeni ovim lekom. 

 

 

Ključne reči:

ankilozirajući spondilitis, pol, kliničke karakteristike, TNF-α inhibitor, neefikasnost

 

 

Abstract

 

Objectives: The aim of this study was to assess gender differences in AS patients regarding the clinical presentation, disease activity, functional status and response to tumor necrosis factor-alpha inhibitor (TNF-α inhibitor) therapy. Methods: This retrospective analysis included 59 AS patients treated with first TNF-α inhibitor for at least 12 weeks. TNF-α inhibitor therapy introduction and response was determined according to ASAS-EULAR management recommendations for AS. Clinical and demographic parameters were compared between the female and male patients. Results: Twenty-four patients (40,68%) were females and 35(59,32%) were males. Women were older than male at moment of study (p=0,049), at the time of diagnosis (p=0,05) and when starting biologic therapy (p=0,009). Moreover, they had a longer diagnosis delay (p=0,017) compared to men. Prevalence of HLA-B27 status and the rate of peripheral arthritis, dactylitis, enthesitis, uveitis or inflammatory bowel disease (IBD) were not different between two groups. Disease activity and functional status were also similar in both groups. Males had a significantly longer drug survival time for first biologic (p=0,031). One female patient (4.2%) and 4 male patients (11,4%) showed primary or secondary inefficacy to TNF-α inhibitor (p=0,61). All 5 non-responders switched to second TNF-α inhibitor and showed a good clinical response. Conclusions: In our cohort, the presence of the female gender was related to longer diagnosis delay compared to males. Non-response rate for the first TNF-α inhibitor was similar between groups, but men had longer drug survival time for the first biologic. 

 

 

Key words:

ankylosing spondylitis, gender, clinical features, TNF-α inhibitor, non-response

 

 

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